Sentinel lymph node biopsy in the management of conjunctival melanoma: current insights

Abstract

Purpose: To evaluate the role of sentinel lymph node biopsy (SLNB) in conjunctival melanoma (CM).

Methods: This article provides a review of the literature from PUBMED.

Results: Data on SLNB in the management of CM are scarce and only two relatively large cohorts have been reported. Although indication criteria for SLNB vary slightly, positive findings can be expected in 11%–13% of CM cases, including small tumors. False negative SLNB findings are rare (<10%). Failure to identify SLNB has been attributed to the surgical learning curve and recurrent tumors with scar tissue impeding spread of the tracer material. Reported 5-year survival rate following CM management including SLNB, is up to 79%, but there are no comparative cohort studies proving the assumed benefit. Adverse events reported were non-severe and transient.

Conclusion: Patients can potentially benefit from SLNB and the procedure can be offered to eligible patients. However, there is not enough evidence to support SLNB as a mandatory part of CM management.

Keywords:

• sentinel
• biopsy
• conjunctival melanoma
• lymphatic spread
• lymph node

Acknowledgments

The authors would like to thank the German Research Foundation (DFG) FOR2240 “(Lymph)-angiogenesis and Cellular Immunity in Inflammatory Diseases of the Eye”, HE 6743/2-1, HE 6743/3-1, and HE 6743/3-2 to LMH; Brigitte and Dr. Konstanze Wegener Foundation to LMH; Ernst and Berta Grimmke Foundation to LMH; and GEROK program of the University of Cologne to JMM and LMH for their tremendous support.

Disclosure

The authors report no conflicts of interest in this work.